Complaint For Dissolution Of Marriage Form Page 4
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7[ ]
There is currently a proceeding which could affect this
action.
(name of court)
(case number)
(date of child custody determination, if any)
(d)
Check the box that applies:
[ ]
I do not know the names and addresses of any persons
other than my spouse and myself who have physical custody
of the child(ren) or claim to have custody or visitation rights
with the child(ren).
OR
[
]
The following is a list of the names and addresses of
persons other than my spouse and myself who have
physical custody of the child(ren) or claim to have custody or
visitation rights with the child(ren).
NAME:
ADDRESS:
__________________________ _____________________________________
__________________________ _____________________________________
12.
_________________________ able to provide support for the child(ren).
(“I am” or “my spouse is”)
13.
During the course of the marriage, my spouse and I have accumulated
certain items of property, which should be equitably divided between us.
Complaint for Dissolution of Marriage (with children), DC 6:5(1),
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PSC Nebraska, Rev. 3/2010.
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